Muito prazer. Pleasure to meet you

Transcription

1 Muito prazer Pleasure to meet you Somos We are a D Or Consultoria: An especialista Insurance em and seguros Benefits e Specialist benefícios

2 We are part of the Rede D Or São Luiz Group HOSPITALS ACCREDITED HOSPITALS. THOUSAND HOSPITAL BEDS ONCOLOGY CLINICS HOSPITAL BEDS UNDER CONSTRUCTION. THOUSAND THAN THOUSAND EMPLOYEES NEW HOSPITALS PROJECTS UNDER EXPANSION

3 Rede D Or São Luiz Hospitals Rio de Janeiro São Paulo Brasília Brasília (Federal (DF) District) Recife Bahia Maranhão

4 Our Figures More than 400 Collaborators R$ 2 Billion de Premium prêmio 1 Over.5 million de vidas administered administradas lives R$ 80 Revenue Our investors Million

5 Some of Our Clients

6 Property/Casualty What is your need? D Or always has a customized solution for your case. And this makes all the difference. Portable Valuables Insurance Did it fall, get wet, break down? We ll help you prevent it. Home Insurance To take even better care of your home, ask for an exclusive quotation. Pet Insurance Friends are to be taken care of. Check out the special conditions to take good care of your pet. Car Insurance Differentiated advantages so you will only worry about the road. Life Insurance If being protected is your priority, you can count on us. Travel Insurance Your trip will give you only unforgettable moments. In a good way... Private Pension Your future is a serious matter. How about planning it in a personalized way?

7 D Or Surety Bond Dedicated Headcount dedicado and Agility Reinsurance Agilidade Bid, Performance, Advance Payment and Supply Bonds Court and Custom Bonds Concession Bonds Custo Cost Bond Types

8 Our Services and differentials What we offer What we offer in addition Operational Management Market Assessment Consulting Access Strength Access to the largest hospital network in Brazil; Service agility; Monitoring of cases and hospitalizations; Concierge project under development. We are a fundamental player for insurance companies; We are on the premium and insurance claim side; The D Or Consultoria portfolio includes more than 1.5 million lives. Risk and Health Management Marketing Technology IRIS and CRYSTAL preventive insurance claim management and auditing of medical accounts (a market innovation); App for the end user; Operational system integrated to the providers database and Human Resources operational systems.

9 The use of data intelligence to tackle risks and reduce costs in healthcare

10 Brazilian Healthcare Market Market Overview (# of Lives) 0.9 MM Philanthropy Public System is funded by the Federal Government but managed locally by state or municipalities 209 MM Universal Public System 142 MM Public System Only (SUS) 47 MM Private Health Care 17.4 MM Cooperatives 18.1 MM Group Medicine/HMO 6.0 MM Insurance Co s Market Size Private Health Care Market is regulated by the ANS o coverage has been standardized o price adjustments for the individual segment (aprox. 22%) are controlled o group contracts can only be purchased through employers, unions and professional associations Second Largest Market in the world 20 MM Closed, Gov. Funded Entities 4.6 MM Self Administered Large Employers

11 Brazilian Healthcare Market: Private and Public 47,435,915 Lives Cost bi Private health: o Smaller portion of lives o Much higher cost per member per month o 156,000 beds o +80% financed by employers Public Private 142,000, bi Public Private Public health: o Larger number of lives o 337,000 beds o Informal employment, small and/or rural businesses and unemployed population o Serious financing problems

12 Public Healthcare in Brazil UNIVERSAL COVERAGE All the public network would serve the population in universal nature, without restrictions or provisions of coverage; EQUITY Equality of Services, everyone would have access to the same type of coverage throughout Brazilian territory NETWORK PROVIDERS The SUS includes not only the federal health networks, but also public networks of states and municipalities MILITARY NOT INCLUDED Medical subsystem of the armed forces remain isolated, not part of the SUS

13 Private Healthcare in Brazil Beneficiaries of private healthcare plans Dec/2000 Jun/2016 Growth from 2000 to 2014 Brazilian economic crisis causes reduction on lives covered by private plans 1,9 million users left the system, mostly because of unemployment Millions downgraded their healthcare plans Sources: ANS 2016

14 Private Sector: Players National Agency (ANS) Healthplan Broker Employer Users Healthcare Providers

15 Private Sector: Players and Services Broker Employers Business Inteligence and Analytics Worksite health programs and obligations Employees Users Wellness and Disease Management Programs Doctors Lab tests Imaging tests Hospitals Support on HR Policies, Market Quotation and Negotiations Regulatory services: ANS and ANVISA Healthplans

16 Healthcare Market in Brazil Private Sector Medical Inflation x Official Inflation Rate

17 Healthcare Market in Brazil Demographic Transition Number of young people (0-14 years) and old people (60 years or more) and Aging Rate Brazil:

18 Healthcare Market in Brazil Number of healthcare plans Dec/2000 Jun/2016 Large number of healthplans, but most are regional Handful of healthplans with quality and national coverage Safe and up-to-date medical providers are mostly concentrated in SP and RJ Medical representative institutions withhold information technology advances and strongly protect physicians Few data to analyse quality and cost-effectiveness of providers and healthplans Shift of funding responsabilities from public private sector Sources: ANS 2016

19 Healthcare Market in Brazil Others Issues: o Asymmetry of information; o Judicialization; o Fee-for-servisse.

20 And what does doing right mean? STRATEGIC MANAGEMENT HEALTH INFORMATION TECHNOLOGY TARGETED ACTIONS Deep understanding of health profile of employees and families Alignment of health benefits policies and other HR actions Integrated approach for all data available Detailed maping of risks and improvement oportunities Monthly evaluations of costs Focus on stimulating preventive measures instead of fighting high cost medicine Effective communication with Employees/Beneficiaries to enhance positive behaviors

21 Trends 2019/20 Economy The era of merges and acquisitions: 40% of private equities went for health Substitutes for biological medications: lower cost per unit but larger number of patients Technology Mobile care: healthcare mobile tools are bursting and Brazil is avid for more Medical devices call for more attention towards information safety New databases should be integrated to rise new insights on how to better manage populational and individual health Behavior and value-based approach Upcoming changes on how we pay for healthcare (cost-based to value-based) will drive providers towards more quality and efficiency This value-based approach will require a better understading of community health and needs Behavior health actions are top strategy for payers to avoid waste, control costs and enhance health

22 Savings in the 1 st year R$700thousand R$300thousand R$900thousand Health programs integrated to the outpatient facilities Hospitalization management Control of elective surgeries Pregnant Women s Program Health Programs: By Your Side Actions in the 3 prevention spheres: primary > secondary > tertiary R$708million in 7 months Benefit policy rearrangement and contribution in the break-up process of companies belonging to the group R$ 19million

23 Savings Globo Network R$1.3million Second medical opinion R$14.2million Price adjustment negotiation R$3.6million Price adjustment negotiation

24 Case 1 Avoided cost of R$ 21,8 millions (15% of total claim) -2,83% 5,46% VCMH Bradesco 2016/2017: 19,77% 2017/2018: 17,13%

25 Case 2 Avoided cost of R$ 9,4 millions (6% of total claim) 11,53% 11,13% VCMH Bradesco 2016/2017: 19,77% 2017/2018: 17,13%